Blue-light reflectance imaging of macular pigment in infants and children

Blue-light reflectance imaging of macular pigment in infants and children

While the role of the macular pigment carotenoids in the prevention of age-related macular degeneration has been extensively studied in adults, comparatively little is known about the physiology and function of lutein and zeaxanthin in the developing eye. We therefore developed a protocol using a di...

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Bibliographic Details
Published in:Investigative ophthalmology & visual science Vol. 54; no. 6; pp. 4034 - 4040
Main Authors: Bernstein, Paul S, Sharifzadeh, Mohsen, Liu, Aihua, Ermakov, Igor, Nelson, Kelly, Sheng, Xiaoming, Panish, Cynthia, Carlstrom, Bonnie, Hoffman, Robert O, Gellermann, Werner
Format: Journal Article
Language:English
Published: United States The Association for Research in Vision and Ophthalmology 10-06-2013
Subjects:
Carotenoids - blood
Carotenoids - metabolism
Child, Preschool
Cross-Sectional Studies
Female
Fovea Centralis - growth & development
Fovea Centralis - metabolism
Fovea Centralis - pathology
Humans
Image Processing, Computer-Assisted
Infant
Infant, Newborn
Light
Lutein - blood
Lutein - metabolism
Male
Models, Biological
Photography
Retinopathy of Prematurity - pathology
Skin - metabolism
Spectrum Analysis, Raman
Xanthophylls - blood
Xanthophylls - metabolism
Zeaxanthins
carotenoid
imaging
lutein
macular pigment
zeaxanthin
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Summary:While the role of the macular pigment carotenoids in the prevention of age-related macular degeneration has been extensively studied in adults, comparatively little is known about the physiology and function of lutein and zeaxanthin in the developing eye. We therefore developed a protocol using a digital video fundus camera (RetCam) to measure macular pigment optical density (MPOD) and distributions in premature infants and in children. We used blue light reflectance to image the macular pigment in premature babies at the time of retinopathy of prematurity (ROP) screening and in children aged under 7 years who were undergoing examinations under anesthesia for other reasons. We correlated the MPOD with skin carotenoid levels measured by resonance Raman spectroscopy, serum carotenoids measured by HPLC, and dietary carotenoid intake. We enrolled 51 infants and children ranging from preterm to age 7 years. MPOD correlated significantly with age (r = 0.36; P = 0.0142), with serum lutein + zeaxanthin (r = 0.44; P = 0.0049) and with skin carotenoid levels (r = 0.42; P = 0.0106), but not with dietary lutein + zeaxanthin intake (r = 0.13; P = 0.50). All premature infants had undetectable macular pigment, and most had unusually low serum and skin carotenoid concentrations. Our most remarkable finding is the undetectable MPOD in premature infants. This may be due in part to foveal immaturity, but the very low levels of serum and skin carotenoids suggest that these infants are carotenoid insufficient as a consequence of low dietary intake and/or severe oxidative stress. The potential value of carotenoid supplementation in the prevention of ROP and other disorders of prematurity should be a fruitful direction for further investigation.
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ISSN:1552-5783
0146-0404
1552-5783
DOI:10.1167/iovs.13-11891